Synopsis: Power wheelchairs allow people living with physical disabilities to be mobile in their homes.

Main Document

Each morning, Margaret Adkins rolls from the bedroom in her apartment to the bathroom to freshen up. Next, she stops in the kitchen to prepare breakfast and then may visit with a friend in their senior citizens complex. Her morning activities are possible because of the power wheelchair that Medicare provides.

Flash back to four years ago.

Adkins, 70, had a knee replacement surgery that did not turn out well. Already suffering from rheumatoid arthritis and fibromyalgia, the knee operation left her virtually immobile - she had a walker but it was far too painful for her to move except when she absolutely had to. She began spending much more of her time in bed.

"My knee was really in pain," she recalls. "Awful pain. I can't even tell you how bad the pain was after I had the new knee put in." She was also falling down, causing bruises that required trips to the doctor. Finally in 2008, her physician prescribed a power wheelchair. Medicare paid for it. And life has been much more rewarding for Adkins.

Like other people living with physical disabilities, Adkins enjoys renewed freedom and independence because the Medicare power mobility benefit has provided her with the wheelchair, which has vastly improved her quality of life.

But will Medicare provide the same level of service in the future

The Centers for Medicare and Medicaid Services has implemented policy and regulatory changes that have put a number of companies out of business or caused them to no longer offer power mobility products. These changes include a 37 percent cut in reimbursements for power wheelchairs over the last three years; a badly flawed competitive bidding program; inconsistent guidance on documenting a patient's medical necessity for the equipment; and a review process that initially denies many claims but then approves reimbursement after appeals that can take months or even years. These factors have raised concerns about whether Medicare beneficiaries who need power wheelchairs are getting them.

The American Association for Home-care (AAHomecare), as well as its member companies and organizations, feel strongly that there needs to be a better understanding of how critical power mobility equipment is to those senior citizens and people living with disabilities who need it. In many instances, a power wheelchair enables someone to no longer be confined to a bed or require assistance in grooming, preparing food and getting to the bathroom. It can mean the difference between living in constant pain or getting pleasure from being able to cook or sit by a window.

"The power wheelchair has made a 100 percent difference in my life," says Adkins, who worked as a caregiver before retiring 10 years ago. "It is a blessing. I go in my bedroom, kitchen, all over. I can go wherever I want to go in my home with my power wheelchair. I wouldn't want to be without my power wheelchair."

Since the mid-1990s, power wheelchairs have allowed people living with physical disabilities to be mobile in their homes. Previously, power wheelchairs were too bulky to make it through a standard doorway. That all changed in 1997. New technology helped reduce the wheelbase to 23 inches, a width that has made a world of difference in the lives of hundreds of thousands of Americans.

Take Stephanie Genge, 66, of Coronado, Calif. She spent much of her life as a chef in Nevada, but in 2003 she moved back to her hometown when arthritis in her back became so bad that she could no longer move around enough to do her job. At first, Genge worked as a cashier at a local pharmacy, but she quit after a few months because of the continued pain. After that, she pretty much stayed in her home, unable to walk without feeling severe pain.

"I could stand up for a few seconds then I had to sit down," Genge recalls. "If I stood up for more than a few seconds, I would fall because everything would just go numb. It was a terrible thing. You don't want to admit that what you have is getting worse, but the pain would not go away."

A year ago, she talked with her physician, who determined that she would benefit from a power wheelchair. Medicare provided the chair, and it made a dramatic change.

"Life is almost fun again," Genge says. "I can cook. I can do the dishes. I can get around my little, old house. The power wheelchair has completely changed my life."

In fact, the power wheelchair has eased the pain so much that she no longer takes pain medication that used to make her ill. And, being pain-free means she can lift weights and exercise her upper body, improving her general health. "I have escaped the pain," she says. "It's amazing what a difference the power wheelchair has made."

Tyler Wilson, president of the AAHomecare, notes that today's power wheelchair is a technological advancement that enables patients who might otherwise be confined to a bed to regain mobility. He says a power wheelchair can restore dignity to some of the most vulnerable people in our society, while allowing them to perform daily necessities of life.

"People often get caught up in the policy and regulatory issues and lose sight of what home medical products, like power wheelchairs, mean to the patients who need them," says Wilson. "As advocates, part of our job is to emphasize to lawmakers and regulators that every power wheelchair that Medicare provides has a profound impact on someone's life."

Mobility Matters is published periodically by the American Association for Home-care (AAHomecare) to inform Congress, the administration, policymakers, consumer organizations and the media about Medicare's power mobility benefit, and the need to sustain it. AAHomecare is committed to helping seniors and people living with disabilities regain their freedom and independence. To learn more about the Medicare power mobility benefit, go to www.aahomecare.org/mobility

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